The present application is a national stage application of PCT Application No. PCT/GB00/00207, filed Jan. 26, 2000, which claims the benefit of United Kingdom Application No. GB 990691.7, filed Jan. 26, 1999.
The present invention relates to compounds and compositions for use in the treatment of conditions generally associated with abnormalities in glutamatergic transmission.
The excitatory neurotransmission underlying brain function is primarily (about 80 per cent) dependent on the action of glutamate and other related neurotransmitters on specific receptors activated by the excitatory amino acids. These receptors fall into several categories, one of which is the glutamate receptor specifically sensitive to the agonist N-methyl-D-aspartate (the NMDA receptor). NMDA receptor subtypes are ubiquitously expressed in mammalian brain and have unique properties underlying their role in synaptic function and plasticity. In view of the central role of these receptors in normal central nervous system function, numerous suggestions have been made as to the utility of drugs acting at this receptor to modulate the processes underlying various disease states. The NMDA receptor has been studied with particular interest in relation to its apparent involvement in the pathophysiology of neurodegenerative diseases.
Non-competitive antagonists at this receptor should be particularly advantageous in the treatment of diseases since such compounds would have activity that should not be overcome by high levels of endogenous agonists and would act equally well independent of the endogenous agonist activating the receptor. This is important since high levels of endogenous glutamate can occur in certain pathological processes and there are a variety of different endogenous agonists that can act through a variety of specific modulatory agonist binding sites on the receptor.
A number of NMDA antagonists have been disclosed which operate by binding to the ion-channel of the NMDA receptor. The advantage of channel blockers is that they operate only on the xe2x80x9copenxe2x80x9d channel and therefore do not affect unactivated receptors. In addition they are effective regardless of the mechanism of receptor stimulation and their effect will not be diminished by large concentrations of endogenous agonist.
Given that the NMDA receptor plays a primary role in normal central nervous system function, it is not surprising that certain drugs acting to block or antagonise the function of this receptor affect normal function within the brain. This may be manifested as central nervous system side effects such as hallucinations, confusion, paranoia, aggression, agitation and catatonia. These side effects can be described as a psychotic state and the drugs that induce them are known as psychotomimetic NMDA antagonists. Such side effects limit the utility of these compounds in treating disease states. NMDA receptor antagonists that have efficacy in treating central nervous system disorders but without such psychotomimetic side effects would have a clear therapeutic advantage. Thus, in view of the crucial role played by the NMDA receptor in either the progression or expression of the disease pathology and process, it is an object of this invention to provide compounds for the treatment of central nervous system disorders which modulate the activity of the NMDA receptor but which are well-tolerated in the sense of having a markedly reduced propensity to induce psychotomimetic side effects.
The present invention is particularly concerned with the treatment of neurodegenerative disorders. There is a large body of evidence to suggest that either an excitotoxic or slow excitotoxic pathological over-activation of the NMDA receptor induces the death of neurons in a variety of disorders such as ischaemic stroke, other forms of hypoxic injury, haemorrhagic brain injury, traumatic brain injury, Alzheimer""s disease, Parkinson""s disease, Huntington""s disease and other dementing diseases. There is thus clear evidence that antagonism of the NMDA receptor will reduce or prevent the neurodegeneration that underlies the disease process in these and related conditions. There is also evidence to suggest that a well-tolerated compound will allow effective symptomatic treatment of the manifestations of the disease process in these disorders as well as reducing the primary underlying neurodegeneration process. Also, it is known that disorders previously described as involving acute neurodegeneration have longer than expected elevations in glutamate release and consequently require longer than expected treatment with NMDA antagonists. There would therefore be a therapeutic advantage for new drugs which are well-tolerated and which can therefore be administered chronically.
The published literature contains references to a number of compounds and classes of compounds purported to be useful as NMDA antagonists.
The compounds Amantadine and Memantine and related anti-viral agents have been known for many years. 
Patent applications have been filed directed to the use of Memantine in the treatment of Parkinson""s Disease in the 1970s and as an NMDA antagonist in 1990 (see EP-A-0392059 and U.S. Pat. No. 5,061,703). Furthermore, International Patent application WO94/05275 proposes the use of Amantadine and related compounds such as Memantine in the treatment and prevention of non-ischaemic, long term NMDA receptor-mediated neuronal degeneration. An increase in affinity for the NMDA receptor due to substitution of the adamantane ring of Amantadine with alkyl groups was noted and published by Komhuber et al. (Eur. J. Pharmacol., 1991, 206, 297-300). Structure-activity relationships relating to 1-(adamantyl)alkanamines are reported by Kroemer et al. (J. Med. Chem.,1998, 41, 393-400), by Parsons et al. (Neuropharmacology, 1995, 34, 1239-1258) and by Fytas et al. (Il Farmaco,1994, 49, 641-647).
As discussed above, psychotomimetic side-effects are observed during the use of a number of well known NMDA channel blockers and therefore it will be a considerable advantage to identify clinically well-tolerated antagonists where such side effects are minimised. Porter and Greenamyre (J. Neurochem. 1995, 64, 614-623; incorporated herein by reference) demonstrated that well-tolerated and psychotomimetic NMDA receptor channel blockers could be differentiated on the basis of their relative affinities for forebrain and cerebellar receptors irrespective of absolute affinities. Selectivity for cerebellar NMDA receptors over forebrain NMDA receptors is observed for well-tolerated compounds. The basis of this observation may be related to different populations of NMDA receptor subtypes in these brain regions.
The use of a number of the known NMDA antagonists such as Dizocilpine, PCP, Cerestat and Ketamine gives rise to a number of side effects which render these compounds unsuitable for use in treatment. In particular, administration of the compounds is associated with perceptual and cognitive disturbances of a kind that resemble naturally-occurring psychotic states.
In addition, the perceptual and cognitive side effects of the compounds become more pronounced after the onset of puberty and sexual maturation, and these compounds are therefore particularly unsuitable for the treatment of adults. This developmental change has been demonstrated empirically in both experimental animals and in man, and is paralleled in experimental animals by brain hypermetabolism.
In summary, there is a need for an NMDA antagonist which is well-tolerated and does not give rise to the side effects associated with previous clinically investigated NMDA antagonists.
A number of compounds have now been found that show affinity for the NMDA receptor and are useful in the treatment of conditions generally associated with abnormalities in glutamatergic transmission such as stroke, traumatic brain injury and neurodegenerative diseases such as Parkinson""s and Alzheimer""s diseases. It has also been found that the compounds have a surprisingly favourable ratio of cortex to cerebellar binding affinity which indicates that these compounds would be well-tolerated in vivo.
According to the present invention there is provided the use of a compound of the formula (1): 
wherein R1, R2, R3, R4, R5 and R6 are independently selected from hydrogen, alkyl and aryl, or pharmaceutically acceptable salts thereof, with the proviso that wherein R1 to R4 and R6 are hydrogen, R5 is not selected from CH2CH2NHSO2CH3, CH2CH2NHSO2CF3 and methyl substituted by SO2NH2, SO3H, PO3H2, CONHOH or a heterocyclic group selected from 
in the manufacture of a medicament for use in the treatment of a condition generally associated with abnormalities in glutamatergic transmission.
As used herein, the term xe2x80x9calkylxe2x80x9d means a branched or unbranched, cyclic or acyclic, saturated or unsaturated (e.g. alkenyl or alkynyl) hydrocarbyl radical which may be substituted or unsubstituted. Where cyclic, the alkyl group is preferably C3 to C12, more preferably C5 to C10, more preferably C5 to C7. Where acyclic, the alkyl group is preferably C1 to C10, more preferably C1 to C6, more preferably methyl, ethyl, propyl (n-propyl or isopropyl), butyl (n-butyl, isobutyl or tertiary-butyl) or pentyl (including n-pentyl and isopentyl), more preferably methyl. It will be appreciated therefore that the term xe2x80x9calkylxe2x80x9d as used herein includes alkyl (branched or unbranched), substituted alkyl (branched or unbranched), alkenyl (branched or unbranched), substituted alkenyl (branched or unbranched), alkynyl (branched or unbranched), substituted alkynyl (branched or unbranched), cycloalkyl, substituted cycloalkyl, cycloalkenyl, substituted cycloalkenyl, cycloalkynyl and substituted cycloalkynyl.
As used herein, the term xe2x80x9carylxe2x80x9d means a substituted or unsubstituted carbocyclic aromatic group, such as phenyl or naphthyl, or a substituted or unsubstituted heteroaromatic group containing one or more, preferably one, heteroatom, such as pyridyl, pyrrolyl, furanyl, thienyl, thiazolyl, isothiazolyl, oxazolyl, isoxazolyl, oxadiazolyl, thiadiazolyl pyrazolyl, imidazolyl, triazolyl, pyrimidinyl pyridazinyl, pyrazinyl, triazinyl, indolyl, indazolyl, quinolyl, quinazolyl, benzimidazolyl, benzothiazolyl, benzisoxazolyl and benzisothiazolyl. In one embodiment, the aryl group comprises phenyl.
The alkyl and aryl groups may be substituted or unsubstituted. Where substituted, there will generally be 1 to 3 substituents present, preferably 1 substituent. Substituents may include:
carbon-containing groups such as
alkyl,
aryl,
arylalkyl (e.g. substituted and unsubstituted phenyl, substituted and unsubstituted benzyl);
halogen atoms and halogen-containing groups such as
haloalkyl (e.g. trifluoromethyl);
oxygen-containing groups such as
alcohols (e.g. hydroxy, hydroxyalkyl, aryl(hydroxy)alkyl),
ethers (e.g. alkoxy, aryloxy, alkoxyalkyl, aryloxyalkyl),
aldehydes (e.g. carboxaldehyde),
ketones (e.g. alkylcarbonyl, alkylcarbonylalkyl, arylcarbonyl, arylalkylcarbon, arylcarbonylalkyl),
acids (e.g. carboxy, carboxyalkyl),
acid derivatives such as esters (e.g. alkoxycarbonyl, alkoxycarbonylalkyl, alkylcarbonyloxy, alkylcarbonyloxyalkyl),
amides (e.g. aminocarbonyl, mono- or di-alkylaminocarbonyl, aminocarbonylalkyl, mono- or di-alkylaminocarbonylalkyl, arylaminocarbonyl),
carbanates (e.g. alkoxycarbonylamino, aryloxycarbonylamino, aminocarbonyloxy, mono- or di-alkylaminocarbonyloxy, arylaminocarbonyloxy), and
ureas (e.g. mono- or di-alkylaminocarbonylamino or arylaminocarbonylamino);
nitrogen-containing groups such as
amines (e.g. amino, mono- or di-alkylamino, aminoalkyl, mono- or di-alkylaminoalkyl),
azides,
nitriles (e.g. cyano, cyanoalkyl),
nitro;
sulfur-containing groups such as
thiols, thioethers, sulfoxides and sulfones (e.g. alkylthio, alkylsulfinyl, alkylsulfonyl, alkylthioalkyl, alkylsulfinylalkyl, alkylsulfonylalkyl, arylthio, arylsulfinyl, arylsulfonyl, arylthioalkyl, arylsulfinylalkyl, arylsulfonylalkyl);
and heterocyclic groups containing one or more, preferably one, heteroatom, (e.g. thienyl, furanyl, pyrrolyl, imidazolyl, pyrazolyl, thiazolyl, isothiazolyl, oxazolyl, oxadiazolyl, thiadiazolyl, aziridinyl, azetidinyl, pyrrolidinyl, pyrrolinyl, imidazolidinyl, imidazolinyl, pyrazolidinyl, tetrahydrofiranyl, pyranyl, pyronyl, pyridyl, pyrazinyl, pyridazinyl, piperidyl, hexahydroazepinyl, piperazinyl, morpholinyl, benzothienyl, benzofuranyl, isobenzofuranyl, indolyl, oxyindolyl, isoindolyl, indazolyl, indolinyl, 7-azaindolyl, indolizinyl, benzopyranyl, coumarinyl, isocoumarinyl, quinolinyl, isoquinolinyl, naphthridinyl, cinnolinyl, quinazolinyl, pyridopyridyl, benzoxazinyl, quinoxalinyl, chromenyl, chromanyl, isochromanyl, phthalazinyl and carbolinyl).
As used herein, the term xe2x80x9calkoxyxe2x80x9d means alkyl-Oxe2x80x94 and xe2x80x9calkoylxe2x80x9d means alkyl-COxe2x80x94 where alkyl is as previously defined.
As used herein, the term xe2x80x9chalogenxe2x80x9d means a fluorine, chlorine, bromine or iodine radical, preferably a fluorine, chlorine or bromine radical.
As used herein the term xe2x80x9cconditions generally associated with abnormalities in glutamatergic transmissionxe2x80x9d primarily includes ischaemic stroke, haemorrhagic stroke, subarrachnoid haemorrhage, subdural haematoma, coronary artery bypass surgery, neurosurgery, traumatic brain injury, traumatic spinal injury, Alzheimer""s disease, Parkinson""s disease, Huntington""s disease, Pick""s disease, Lewy body disease, senile dementia, spongiform encephalopathies, prion-protein induced neurotoxicity, peri-natal asphyxia, demyelinating disease, multiinfarct dementia, vascular dementia, dementia pugilans, drug dependence, alcohol withdrawal, opiate withdrawal, motor neurone disease, multiple sclerosis, acute and chronic pain including neuropathic pain, cancer pain, trigeminal neuralgia, migraine, primary and secondary hyperalgesia, inflammatory pain, nociceptive pain, tabes dorsalis, phantom limb pain, spinal cord injury pain, central pain, post-herpetic pain, HIV pain and diabetic neuropathy. In addition, the term also includes the following conditions: epilepsy, AIDS dementia, multiple system atrophy, progressive supra-nuclear palsy, Friedrich""s ataxia, autism, fragile X syndrome, tuberous sclerosis, attention deficit disorder, olivio-ponto-cerebellar atrophy, cerebral palsy, drug-induced optic neuritis, peripheral neuropathy, myelopathy, ischaemic retinopathy, glaucoma, cardiac arrest, meningitis, encephalitis, depression, bi-polar disorder, schizophrenia, psychosis, behaviour disorders, impulse control disorders, pre-eclampsia, neuroleptic malignant syndrome, chronic fatigue syndrome, anorexia nervosa, anxiety disorders, generalised anxiety disorder, panic disorder, phobias, fresh water drowning and decompression.
As used herein, the term xe2x80x9ctreatmentxe2x80x9d includes prophylactic treatment.
As used herein, the term xe2x80x9cpharmaceutically acceptable saltxe2x80x9d means any pharmaceutically acceptable salt of the compound of formula (1). Salts may be prepared from pharmaceutically acceptable non-toxic acids including inorganic and organic acids. Such acids include acetic, benzenesulfonic, benzoic, camphorsulfonic, citric, dichloroacetic, ethenesulfonic, fumaric, gluconic, glutamic, hippuric, hydrobromic, hydrochloric, isethionic, lactic, maleic, malic, mandelic, methanesulfonic, mucic, nitric, pamoic, pantothenic, phosphoric, succinic, sulfuric, tartaric, oxalic, p-toluenesulfonic and the like. Particularly preferred are hydrochloric, hydrobromic, phosphoric, fumaric, succinic, methanesulphonic and sulfuric acids, and most particularly preferred is the hydrochloride salt.
The compounds of formula (1) may exist in a number of diastereomeric and/or enantiomeric forms. Reference in the present specification to xe2x80x9ca compound of formula (1)xe2x80x9d is a reference to all stereoisomeric forms of the compound and includes a reference to the unseparated stereoisomers in a mixture, racemic or non-racemic, and to each stereoisomer in its optically pure form.
The compounds of the present invention are active as NMDA antagonists and are well-tolerated in that side-effects are minimised. Experimental data are shown in Table 1.
In the compounds of formula (1), preferably one or more of R1, R2, R3, R4 and R6 are hydrogen. In a preferred embodiment of the present invention, one or both of R1 and R2 are hydrogen. In a further preferred embodiment, one or both of R3 and R4 are hydrogen. In a further preferred embodiment all of R1, R2, R3, R4, and R6 are hydrogen.
In the compounds of formula (1), preferably R5 is alkyl or aryl, more preferably R5 is aryl.
Where R5 is alkyl, preferably R5 is an acyclic hydrocarbyl radical, preferably saturated, preferably unbranched and preferably unsubstituted. In one embodiment, R5 is alkyl substituted by a substituted or unsubstituted carbocyclic aromatic group, preferably a phenyl group, or a substituted or unsubstituted heteroaromatic group containing 1 or 2, preferably 1, heteroatom and preferably a thienyl, pyridyl or furanyl group.
Where R5 is aryl, preferably R5 is a substituted or unsubstituted carbocyclic aromatic group or a substituted or unsubstituted heteroaromatic group containing 1 or 2 heteroatoms, preferably one heteroatom. More preferably, R5 is a carbocyclic aromatic group, preferably phenyl, substituted or unsubstituted. Where substituted, R5 is preferably mono-substituted. Where R5 is a mono-substituted phenyl group, the substituent is preferably in the meta or para position, and more preferably the meta position, of the phenyl ring with respect to the adamantane group. Preferred substituents are selected from C1 to C4 alkyl, preferably methyl and ethyl; halogen, preferably fluorine and chlorine; alkoxy, preferably methoxy; and haloalkyl, preferably trifluoromethyl. Preferably R5 is selected from phenyl, 3-methylphenyl, 4-methylphenyl and 3-ethylphenyl. More preferably R5 is selected from 3-methylphenyl and 3-ethylphenyl. Most preferably R5 is 3-methylphenyl. In the embodiment where R5 is a heteroaromatic group, it is preferred that R5 is selected from thienyl, pyridyl and furanyl groups, most preferably thienyl, substituted or unsubstituted.
In one embodiment of the invention, the compounds are selected from compounds other than those wherein R1, R2, R3, R4 and R6 are hydrogen and R5 is either C1-2 alkyl substituted by sulfonamide, amide, phosphonic acid, sulfonic acid, hydroxamic acid or a heterocyclic group or R5 is a heterocyclic group, particularly wherein said heterocyclic group is a heteroaromatic group, and particularly wherein the heterocyclic group contains 3 or more heteroatoms.
In a further embodiment of the invention, the compounds are selected from compounds other than those wherein R1, R2, R3, R4 and R6 are hydrogen and R5 comprises a group which is a sulfonamide, amide, phosphonic acid, sulfonic acid, hydroxamic acid or a heterocyclic group, particularly wherein said heterocyclic group is a heteroaromatic group, and particularly wherein said heterocyclic group contains 3 or more heteroatoms.
In an alternative embodiment of the invention, the compounds are selected from compounds other than those wherein R1, R2, R3, R4 and R6 are hydrogen and R5 is not selected from CH2CH2NHSO2CH3, CH2CH2NHSO2CF3 and methyl substituted by SO2NH2, SO3H, PO3H2, CONHOH or a heterocyclic group selected from tetrazol-5-yl, 5-oxo-4H-[1,2,4]oxadiazol-3-yl, 5-thioxo-4H-[1,2,4]oxadiazol-3-yl, 5-oxo-4H-[1,2,4]thiadiazol-3-yl and 2-oxo-2,3-dihydro-[1,2,3,5]oxathiadiazol-4-yl. In a further alternative embodiment of the invention, the compounds are selected from compounds other than those wherein R1, R2, R3, R4 and R6 are hydrogen and R5 comprises a group which is a sulfonamide, amide, phosphonic acid, sulfonic acid, hydroxamic acid or a heterocyclic group selected from tetrazol-5-yl, 5-oxo-4H-[1,2,4]oxadiazol-3-yl, 5-thioxo-4H-[1,2,4]oxadiazol-3-yl, 5-oxo-4H-[1,2,4]thiadiazol-3-yl and 2-oxo-2,3-dihydro-[1,2,3,5]oxathiadiazol-4-yl.
Particularly preferred compounds are 2-(3-ethylphenyl)-2-adamantanemethanamine, 2-(3-methylphenyl)-2-adamantanemethanamine, 2-phenyl-2-adamantanemethanamine and 2-(4-methylphenyl)-2-adamantanemethanamine, and the hydrochloride salts thereof.
The present invention further provides a method of treatment of conditions generally associated with abnormalities in glutamatergic transmission comprising administering to a patient an effective dose of a compound of formula (1) as defined above, or pharmaceutically acceptable salts thereof.
The present invention also provides, for use in therapy, a compound of formula (1) as defined above and pharmaceutically acceptable salts thereof, other than compounds in which R3, R4, R5 and R6 are hydrogen and one of R1 and R2 is hydrogen, methyl or benzyl and one of R1 and R2 is a substituted methyl, ethyl or propyl group, and other than the compounds in which R1, R2, R5 and R6 are hydrogen and R3 and R4 are selected from methyl and aminomethyl.
In a preferred embodiment, the present invention provides, for use in therapy, compounds of formula (1) as defined above and pharmaceutically acceptable salts thereof, other than compounds in which R3, R4, R5 and R6 are hydrogen and R1 and R2 are independently selected from alkyl and other than compounds in which R1, R2, R5 and R6 are hydrogen and R3 and R4 are independently selected from alkyl.
In an alternative preferred embodiment, the present invention provides, for use in therapy, compounds of formula (1) as defined above and pharmaceutically acceptable salts thereof, wherein
(i) R3, R4, R5 and R6 are independently selected from hydrogen, alkyl and aryl and R1 and R2 are independently selected from hydrogen and aryl; or
(ii) R3, R4, R5 and R6 are independently selected from alkyl and aryl and R1 and R2 are independently selected from alkyl; or
(iii) R1, R2, R5 and R6 are independently selected from hydrogen, alkyl and aryl and R3 and R4 are independently selected from hydrogen and aryl; or
(iv) R1, R2, R5 and R6 are independently selected from alkyl and aryl and R3 and R4 are independently selected from alkyl.
In a further preferred embodiment, the present invention provides, for use in therapy, compounds of formula (1) as defined above and pharmaceutically acceptable salts thereof, wherein R5 and R6 are independently selected from alkyl and aryl.
In a particularly preferred embodiment, the present invention provides, for use in therapy, compounds of formula (1) as defined above and pharmaceutically acceptable salts thereof, wherein R5 is selected from alkyl and aryl.
The present invention also provides a compound of the formula (1) as defined above and pharmaceutically acceptable salts thereof, wherein R5 is selected from alkyl and aryl, with the proviso that where R1 and R2 are methyl and R3, R4 and R6 are hydrogen, R5 is not hydroxymethyl.
According to a further aspect of the present invention there is provided a method of preparing the compounds of the formula (1) as defined above wherein R5 is selected from alkyl and aryl, other than the compounds in which R1 and R2 are methyl, R3, R4 and R6 are hydrogen and R5 is hydroxymethyl.
Compounds of formula (1) may be prepared by conventional synthetic routes, for example compounds where R1, R2, R3 and R4 are all hydrogen may be prepared as illustrated in Reaction Scheme 1. 
Amines (5) are prepared by reduction of the corresponding nitrile (4) by standard methods such as borane. Nitriles (4) are prepared from alcohols (3) by standard methods such as TMSCN in the presence of BF3. Alcohols (3) are prepared by addition of, for example, Grignard reagents to the corresponding 2-adamantanones (2) which may be available commercially or are synthesised by standard methods.
Compounds of formula (1) where R1 and/or R2 are alkyl may be prepared from amines (5) by standard methods including alkylation, reductive alkylation or acylation/reduction.
Compounds of formula (1) where R1 and/or R2 are aryl may be prepared from amines (5) by standard methods such as palladium-catalysed coupling to aryl halides.
Compounds of formula (1) where R3 and/or R4 are alkyl or aryl may be prepared from nitriles (4) by standard methods such as the addition of metallated alkyl or aryl anions.
Compounds of formula (1) where R1, R2, R3 and R4 are not all hydrogen may also be prepared as illustrated in Reaction Scheme 2. 
Amines (6) where R3 is alkyl or aryl may be prepared from nitriles (4) by standard methods such as addition of a metallated alkyl or aryl anion followed by reduction.
Amines (8) where R3 is hydrogen, alkyl or aryl may be prepared from ketones (7) by standard methods such as reductive amination. Ketones (7) where R3 is alkyl or aryl may be prepared from nitriles (4) by standard methods such as addition of a metallated alkyl or aryl anion followed by hydrolysis. Ketones (7) where R3 is hydrogen may be prepared from nitriles (4) by standard methods such as reduction.
Amines (10) where R3 and R4 are alkyl or aryl may be prepared from i mines (9) by standard methods such as addition of a Grignard reagent. Amines (10) may be converted to further compounds of formula (1) as described above. Imines (9) where R3 is alkyl or aryl and R1 is alkyl or aryl may be prepared from ketones (7) by standard methods such as treatment with an amine. Alternatively imines (9) where R1 is alkyl may be prepared from nitriles (4) by addition of a metallated alkyl or aryl anion followed by treatment, for example, with an alkyl halide.
The present invention further provides a pharmaceutical composition comprising the compound of the formula (1), or a pharmaceutically acceptable salt thereof, in combination with a pharmaceutically acceptable excipient.
The compound of formula (1) may be administered in a form suitable for oral use, for example a tablet, capsule, pellet, aqueous or oily solution, suspension or emulsion; for topical use including transmucosal and transdermal use, for example a cream, ointment, gel, aqueous or oil solution or suspension, salve, patch or plaster; for nasal use, for a example a snuff, nasal spray, nasal powder or nasal drops; for vaginal or rectal use, for example a suppository or pessary; for administration by inhalation, for example a finely divided powder or a liquid aerosol; for sub-lingual or buccal use, for example a tablet or capsule for ocular use, for example a sterile aqueous solution or sterile ointment; or for parenteral use (including intravenous, subcutaneous, intramuscular, intravascular or infusion), for example a sterile aqueous or oil solution or suspension or emulsion, or depot injection formulation. In general the above compositions may be prepared in a conventional manner using conventional excipients, using standard techniques, including controlled release technologies, such as gelatin, lipid, gel depot, liposome and microcapsule based systems well known to those skilled in the art of pharmacy.
For oral administration, the compounds of the invention will generally be provided in the form of tablets or capsules or as an aqueous solution or suspension.
Tablets or pellets for oral use may include the active ingredient mixed with pharmaceutically acceptable excipients such as inert diluents, disintegrating agents, binding agents, lubricating agents, sweetening agents, flavouring agents, colouring agents and preservatives. Suitable inert diluents include sodium and calcium carbonate, sodium and calcium phosphate, calcium hydrogen phosphate, cellulose derivatives, and lactose, while corn starch and alginic acid are suitable disintegrating agents. Binding agents may include starch, gelatin and polyvinyl-pyrrolidone derivatives, while the lubricating agent, if present, will generally be magnesium stearate, stearic acid or talc. If desired, the tablets may be formulated or coated with a material such as glyceryl monostearate or glyceryl distearate or polymethacrylate polymers, cellulose derivatives or other pharmaceutically acceptable polymer, to delay absorption in the gastrointestinal tract.
Capsules for oral use include hard gelatin capsules in which the active ingredient is mixed with a solid diluent, and soft gelatin capsules wherein the active ingredient is mixed with water or an oil such as peanut oil, liquid paraffin or olive oil.
For intramuscular, intraperitoneal, subcutaneous and intravenous use, the compounds of the invention will generally be provided in sterile aqueous solutions or suspensions or emulsions, buffered to an appropriate pH and isotonicity. Suitable aqueous vehicles include Ringer""s solution and isotonic sodium chloride. Aqueous suspensions according to the invention may include suspending agents such as cellulose derivatives, sodium alginate, polyvinyl-pyrrolidone and gum tragacanth, and a wetting agent such as lecithin. Suitable preservatives for aqueous suspensions include ethyl and n-propyl p-hydroxybenzoate.
Transdermal formulations include membrane permeation systems, multi-laminate adhesive dispersion systems and matrix dispersion systems. Transdermal delivery also includes the use of electrically aided transport and skin penetration enhancers and needle-free injection devices.
The preferred route of administration will be as an intravenous infusion, preferably over a period of up to seven days, or as an oral formulation, or as an intramuscular injection via a styrette or as a subcutaneous injection.
It will be appreciated that the dosage levels used may vary over quite a wide range depending upon the compound used, the severity of the condition exhibited by the patient and the patient""s body weight. However, without commitment to a rigid definition of dosages it may be stated that a daily dosage of the active constituent (estimated as the free base) is 100 xcexcg to 800 mg. More particularly the preferred compounds may be administered at a preferred dose of 50-800 mg daily in single or divided doses.